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Post by Fletchsmile on May 23, 2018 12:06:00 GMT 7
In general I've not been a big fan of health insurance plans in Thailand.
Ok When employed I don't mind, when it's at the company's cost. But at a personal level, when I've been paying, I've chosen to self-insure.
Some of the drawbacks in Thailand for health insurance (and insurance generally) include:
-high costs -not good value for money. Thailand is a growth market for insurers because of high margins. Paid for of course by the customer
-what happens the following year when you make a claim. People say bankers lend you an umbrella until it rains. The parallel for insurers: you pay daily for an umbrella, but if you use it, next year they won't let you use it or make it prohibitively expensive to do so. (eg. Exclude the condition next year, don't let you renew or up the premiums) -essentially you may be only protecting 1 year. What happens after that 1 year when your contract comes up again if you have made no other provisions? Why not start making other provisions now for when they won't insure you on decent terms.
-age exclusions -previous history exclusions etc etc
Then there's some of the positives of self-insurance: -Flexibility in your finances and preparations. Worth mentioning, if something happened in early years for a big amount (the big risk), we also have access to low cost funding arrangements, eg borrow SGD at just over 2%, as another option
-Statistically you will likely be better off. (But of course you are trading this for the risk of a very big game changer that wipes you out if not adequately prepared) -Economies of scale if you have several family members. Your own mini pooling of risks on a smaller scale to what insurers do -Ability to plan better across multiple years. (But of course, early years are higher risk)
-No claims = no costs
etc etc
For our family, the ideal level of health cover I want, will cost over THB 200k. I prefer to put this towards things like school fees, investments etc
As an example Aetna's Platinum plan with THB 5 million of cover, just about scrapes the minimum ideal I would want, and would cost our family of 4, 160k or about 13k a month. Even then if it is over THB 5mn we're not covered. So it's not covering the really big life changers. (5mn would be an uncomfortable hit but affordable). Also if a 5mn claim is made for an ongoing illness, so I doubt that would be covered next year.
So I prefer saving/investing 200k a year as a reserve.
After 10 years of doing that each year at 7% investment returns, without drawing on it, that would be ball park THB 3mn, with premiums/200k in advance.
20 years approx 8.7mn,
30 years, approx 20mn. 40 years, approx 43mn
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Post by Fletchsmile on May 23, 2018 13:11:24 GMT 7
One thing though is to keep an open mind and not be too dogmatic either way. Recently I came across a product from Aetna, which others on here might be interested in. It won't suit everyone by any means, but may be useful to some. www.aetna.co.th/en/individuals/health-insurance/individual/detail.aspx?iid=4#.WwUAO_nRDIUIt also helped reinforce my view that it also doesn't have to be either or. i.e you might insure part to lay off some of the risk, and self-insure part. Yesterday I applied for 4 plans for our family members, with Aetna. We are using it as a stand alone product. Combined cost was about THB 24k p.a. in total for the 4 of us. That's only THB 2k a month Coverage is worldwide (excluding US. Although emergency in US is covered) Pay out 80% of the XS over 20k, Pay out up to a max payout per plan of 600k a year Room and board on top paid out in full, but capped at 4k a day I'm most expensive and am about 1/3 the total with our youngest second most expensive. Me 685 baht per month Wife 476 per month Daughter 1, 355 per month Daughter 2, 482 per month So ball park that's a total cover of 4x600k = 2.4mn for a cost of about 24k p.a. or 1% p.a. on average. By comparison their Platinum package for 4x5mn = 20mn coverage would cost us about 160k p.a. or 0.8% p.a. on average. Better value in many ways, but also a significantly larger cost There's no one case fits all when it comes to insurance issues, but... Some of the reasons why I feel it suits us: - I've no worries on paying the first 20k. That's peanuts - I don't mind a payout of only 80% and paying 20% myself - Doesn't include OPD (outpatient) on our option. OPD I'll pay as we go along. OPD significantly increases costs, and being out patient by nature is usually only small ticket items
- 600k payout is sort of a mid range cover in Thailand. It won't fully cover the most serious cases/ tail risk/ biggest ticket items, but will cover most of the cost for things like couple of weeks in ICU, heart by-pass, etc, as well as providing some contribution to the big ticket low probability items - Covers part of the risk if we were all 4 unluckily hit at the same time - If I did work in future for someone that doesn't fully cover me/all 4 of us, this is flexible on top extra
- Worldwide. Means we have can show coverage to a hospital that we have some insurance - Provides an additional "buffer" before we start significantly touching any self-insurance provisions made - Allows us to save up/invest other amounts that more expensive insurance would cost
Obviously it's not going to cover full costs on everything. It will make a contribution though, and I supplement it with self insurance. What it does though is cover a decent % of the costs, particularly on mid-range seriousness, and particularly in Thailand, for a small cost of only 2k a month (a mild night out) for a family of 4.
I really don't fancy paying 160k - 200k+ per year, for something that may never happen. But 24k a year, doesn't seem like much, and means we can set aside the large difference each year for other things including saving/investing/self-insurance.
It may also suit someone in the early years building up that self-insurance reserve. Above is for family of 4. But something worth considering also for a single guy also starting from scratch. They could pay under 1k a month (likely 400-700 baht a month) for some/partial cover and save/invest the balance
Cheers Fletch  |
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Post by Fletchsmile on May 23, 2018 15:21:36 GMT 7
Just had a call from Aetna. They rejected my application, but have approved for our other 3 family members. Mine was rejected as I declared I had skin cancer 7 years or so back. I said often companies could just exclude that and any other histories from coverage (particularly if over 5 years), but that seems to have gone over their heads  . They did say they'd contact me if any changes in the future They said the application would normally be rejected if you've had any of the major diseases list. There we go again with the insurers taking away your umbrella if you ever use it So seems this type of cover would mainly be of interest to younger people/ those with no history of major illnesses. The Mrs said to just cancel all 4 plans. But I said may as well keep the other 3. We're not relying on this alone in terms of provisions for health, and it's only designed to reduce part of the possible costs and lay off some of the risk. On the bright side, cost will now be around THB 1,300 a month or THB 16,000 a year on 600,00x3 = 1.8mn total. That's only 0.9% p.a. |
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Post by Fletchsmile on May 23, 2018 18:15:40 GMT 7
In another twist I got an email saying they will issue me a policy if I sign an exclusion form to exclude skin cancer. That makes much more sense. I suspect the Thai sales person managing our policies had some communication issues.
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Post by rgs2001uk on May 23, 2018 22:39:03 GMT 7
I sometimes wonder if there are actually any proper health insurance schemes available here, many of them seem to be some sort of money saving plan, cassasurance?
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Post by Fletchsmile on May 24, 2018 10:22:37 GMT 7
Yes the ones that combine savings/investments with insurance are often poor value for money. Keep your investments and insurance on separate policies is a good rule of thumb to follow.
The policies above are health insurance only. No savings/investment element. The relatively low premiums (for Thailand) allow us to invest elsewhere of our own choice.
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GavinK
Crazy Mango
Posts: 101
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Post by GavinK on May 24, 2018 11:09:46 GMT 7
The real test of any insurer is when you make a claim. My experience with the various providers I've used :
- Aetna - slow to settle but generally ok
- AXA - poor administration (eg. if you want to change your bank account). Sometimes reject valid claims (eg. rejected a "nursing/widwifery" charge on an invoice for me saying midwifery was not covered. I told them to check the invoice name "Mr"... But aside from poor admin they are generally ok.
- BUPA - not sure if they are still here but would never use again. My recollection is that they tried to dispute any claim. Used for 1 year only.
- Medicare (UK company) - expensive but never had any issues with them.
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Post by Fletchsmile on May 24, 2018 17:31:55 GMT 7
The real test of any insurer is when you make a claim. My experience with the various providers I've used : - Aetna - slow to settle but generally ok - AXA - poor administration (eg. if you want to change your bank account). Sometimes reject valid claims (eg. rejected a "nursing/widwifery" charge on an invoice for me saying midwifery was not covered. I told them to check the invoice name "Mr"... But aside from poor admin they are generally ok. - BUPA - not sure if they are still here but would never use again. My recollection is that they tried to dispute any claim. Used for 1 year only. - Medicare (UK company) - expensive but never had any issues with them. In Thailand I BUPA's business was take over by Aetna. There are some FAQ's on that here:
and a quote from it as below...
Other insurances I've had in the past (mainly thru employers) were:
- Allianz Worldwide. They seem fine for claims and no bother. Our first daughter's birth was covered on this and they paid up quickly without question. I think with it being a worldwide / global policy issued outside Thailand helped. I think they took one look at the cost and thought "that's cheap for a private delivery" and just paid it. Was around THB 60k at Bumrungrad at the time. I'm sure you'd have been looking GBP 5k up privately
- AIA were OK. Never really claimed much on it though, except outpatient small amounts. Would never have bought OPD myself, but it was provided by an employer
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Post by Fletchsmile on Jun 8, 2018 17:37:59 GMT 7
I received the letter below from Aetna in connection with my application. If you received it, would you assume: 1) They will issue your policy subject to an exclusion for skin cancer if you complete the form and attach it back
2) The application is rejected and no policy will be issued
Just a (in)sanity check ================================================================ Date 23/05/2018 TO Fletch Smile CC Sales Person RE: Health Application :- UW18-40290: Fletch Smile Dear Sir / Madam: Following a review of your application for health insurance, our medical underwriter has recommended certain exclusions to your policy. We are there unable to reimburse medical expenses for the following conditions and diseases: Fletch Smile Reject (previous skin cancer) I would be grateful, therefore if you could confirm whether you accept these exclusion(s) to your policy by signing below and returning a copy of this letter or by fax or confirm by e-mail as the contact address below. A prompt reply would be appreciated to process your policy. Your policy will not be effective until confirmation is received. Thank you for your assistance. Yours sincerely, Ann Underwriter Underwriting section Please sign to acknowledge the above exclusion(s) and send back to Aetna Health Insurance (Thailand) Public Company Limited immediately. We reserve the right to attach the above exclusion(s) to your policy. □ Yes, I accept the exclusion(s) and please issue my policy □ No, I do not accept the exclusion(s) ……………………………………… (Please provide documentary evidence why the exclusion(s) should not be applied.) Signature …………..………….. Date…………………………….. Please contact A Sales person Telephone no. 0-1234-5678 FAX. no 0-1234-5679 E-Mail xxxxx@AETNA.CO.TH |
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Post by Fletchsmile on May 16, 2019 17:22:53 GMT 7
Thought I would resurrect this thread, so people could post any plans, etc they have.
Particularly with in mind the possibility of the need for 400K in patient and 40k OPD cover that might be needed for some visas.
Don't want to get into discussing the merits of the visa requirments as their are other threads on that. But might be useful to start collecting links on providers, policies etc
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Post by Fletchsmile on May 16, 2019 17:31:31 GMT 7
As mentioned above, I have 3 small policies to cover the wife and kids with Aetna. We use the Extra Care program Plan 4= no OPD = pays out up to 600k per policy on inpatient. = we pay the first 20k = what can be claimed as 80% of the excess above 20k up to a max claim of 600k We now have a 10% discount. After a year of no claims My rationale for taking out: > It's basic but cheap. > Doesn't waste money on OPD. > Worldwide excl USA > Cost is about THB 15k a year in total (we pay monthly by DD to my credit card) for the 3 policies. > Compared to a payout of 1.8 mn max (600k x3) that's a multiple of 120, or put another way cost is less than 1% combined for the coverage, which is not unreasonable > it lays off some off the risk sor a small outlay. insurance doesn't need to be all or nothing
Note: They wouldn't insure me, as I'd previously had skin cancer.
For a 50 year old, that 600k cover would cost about 8,640 baht a year which is about 1.4% of the max payout, so wouldn't exactly break the bank. Although over the 400k for IPD needed for visas it has no OPD, so unlikely to be able to used for visas.
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Post by Fletchsmile on May 16, 2019 17:37:42 GMT 7
The LongStayVisa insurance listed companies are on the following website. They show amounts for different ages etc, with plans that would cover 400k IPD and 40K, though a bit higher coverage is also possible ==================================== longstay.tgia.org/The listed companies who participate in this scheme. AXA INSURANCE PUBLIC COMPANY LIMITEDAXA Insurance PCL was established in Thailand in July 1998 and AXA Group is the major shareholder of our company. The company’s operation has been expanding steadily over the years through the strong support from the shareholders, business partners, insurance brokers, and agents including the fast growing number of satisfied customers. The company is committed to “the excellence by being available, attentive and reliable to our customers”. BANGKOK INSURANCE PUBLIC COMPANY LIMITEDBangkok Insurance Public Company Limited is a leading non-life insurer in Thailand offering comprehensive health insurance products with a nationwide network of contracted hospitals as well as a wide range of other non-life insurance products. With over 70 years of operations in Thailand, we are the preferred non life insurer in the country. Our dedicated staff is always ready to assist you as “Your Caring Partner.” THE VIRIYAH INSURANCE PUBLIC COMPANY LIMITEDThe Viriyah Insurance (Public) Company Limited is Thailand’s number one non-life insurance company that has maintained the leadership in the industry over a long period of time. The company is recognized for its extensive experiences of service quality, worthwhile protection, and transparency. Health insurance is one of our prides that we provide a range of cover to suit your needs and provide you the standard of health claims service that delivers the protection and cares when you need it most. PACIFIC CROSS HEALTH INSURANCE PUBLIC COMPANY LIMITEDPacific Cross International Limited has specialized in health insurance in Asia for over 45 years. It owns several reputable health insurance companies of the past and present (Blue Cross Insurance Incorporation in Philippines, Blue Cross Thailand and Hongkong). Pacific Cross Health Insurance PCL is part of the Pacific Cross Group, the leading travel and medical insurance specialist in Asia. THAIVIVAT INSURANCE PUBLIC COMPANY LIMITEDWith 66 years experience and supported by leading global reinsurers, Thaivivat Insurance Pcl. developed this Health product especially for the long-term visitor to Thailand. Serviced NAVAKIJ INSURANCE PUBLIC COMPANY LIMITEDFor over 84 years, The Navakij Insurance Public Company Limited is professional Thai non-life insurance company. There are 28 service offices located nationwide. |
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Post by Fletchsmile on May 16, 2019 17:44:14 GMT 7
Some policies from Thai Lifewww.thaihealth.co.th/2012/product_simply_eng.phpDon't strike me as particularly good value, but may be OK for visas if you pick the right ones eg SP4000 for IPD of 400k combined with OPD 1000 of 40k prima facie meets visa requirements would cost 16,965 + 9,206 = approx 26k for a 50 year old |
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Post by Fletchsmile on May 16, 2019 17:50:56 GMT 7
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AyG
Crazy Mango Extraordinaire
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Post by AyG on May 16, 2019 18:03:03 GMT 7
However, they won't cover retirees who aren't married to a Thai person. (Not atypical discrimination against gay people here.) Since the new insurance rules apparently related to people on an O-A visa (who typically aren't married), this isn't going to be helpful, methinks. Incidentally, when the requirement is for 400k inpatient, surely that means up to that for a single incident. This policy has a per IPD incident maximum of 50,000. I don't know about these things, but surely that's not going to be acceptable. |
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. They did say they'd contact me if any changes in the future 
